Chapter 05: Nursing Care of Women with Complications During Pregnancy

1. A pregnant patient tells the nurse that she has been nauseated and vomiting. The nurse explains that hyperemesis gravidarum is distinguished from morning sickness because:

b. hyperemesis gravidarum causes dehydration and electrolyte imbalances.

2. A woman who is 9 weeks pregnant is experiencing heavy bleeding and cramping. She reports passing some tissue. Cervical dilation is noted on examination. This woman most likely had a(n) _____ abortion.

b. incomplete

3. The nurse finds a woman crying after she has undergone a dilation and evacuation (D&E) for a missed abortion. The most appropriate statement made by the nurse would be:

c. "I'm here if you need to talk."

4. A woman who is 8 weeks pregnant becomes concerned when she has light vaginal bleeding accompanied by abdominal pain. An ectopic pregnancy is confirmed by ultrasound. The statement that indicates that the woman understands the explanation of an ectopic pregnancy is:

d. "The embryo is implanted in the fallopian tube."

5. An ultrasound on a woman who is 32 weeks pregnant reveals the placenta implanted over the entire cervical os. The nurse understands that this condition is known as:

d. total placenta previa.

6. The nurse would suspect abruptio placentae when the pregnant woman presents with:

c. vaginal bleeding and back pain.

7. Rh incompatibility occurs in which situation?

a. Rh-negative mother, Rh-positive fetus

8. A primigravida in her first trimester is Rh negative. To prevent anti-Rh antibodies from forming, this woman would receive:

c. Rh immune globulin at 28 weeks and within 72 hours after the birth of an Rh-positive infant.

9. A woman seeking prenatal care relates a history of macrosomic infants, two stillbirths, and polyhydramnios with each pregnancy. The nurse recognizes that these factors are highly suggestive of:

d. diabetes mellitus.

10. The nurse explains that pregnancy affects glucose metabolism because:

a. placental hormones increase the resistance of cells to insulin.

11. The nurse explains that a woman who uses oral hypoglycemic agents to control diabetes mellitus will need to take insulin during pregnancy because:

b. insulin does not cross the placental barrier to the fetus.

12. The pregnant woman comes to the clinic stating that she has been exposed to hepatitis B. She is afraid that her infant will also contract hepatitis B. The nurse counsels that the infant will:

a. be given a single dose of hepatitis immune globulin after birth.

13. When the nurse asks a patient about drug use during a prenatal history, she might begin the questioning with:

c. "What over-the-counter and prescription drugs have you taken in the past 3 months?"

14. The nurse assesses a pregnant woman for pregnancy-induced hypertension. The first sign of fluid retention suggestive of this complication is:

c. sudden weight gain.

15. If the patient with gestational hypertension has all the signs below, the nurse immediately should report:

c. blurred vision.

16. The patient who is 28 weeks pregnant presents with consistent hypertension. The home health nurse would give priority to the need for:

a. activity restriction.

17. The nurse explains that the objective of magnesium sulfate therapy for the patient with preeclampsia is to:

a. prevent convulsions.

18. The nurse caring for a pregnant woman receiving an intravenous infusion with magnesium sulfate will:

a. count respirations and report a rate of less than 12 breaths/min.

19. The drug the nurse plans to have available for immediate IV administration whenever magnesium sulfate is administered to a maternity patient is:

c. calcium gluconate.

20. A woman who is 35 weeks pregnant has a total placenta previa. She asks the nurse, "Will I be able to deliver vaginally?" The nurse should explain:

c. "A cesarean section is performed when the mother has a total placenta previa."

21. The nurse teaches a woman who is 8 weeks pregnant about how rubella can affect the developing fetus. The nurse realizes the woman understands the information when she says that rubella during pregnancy can result in:

b. mental retardation.

22. The nurse would suspect pyelonephritis when a pregnant woman reports:

d. tenderness in the flank area.

23. To help prevent more placental damage, the nurse positions the prenatal patient with a placenta previa:

b. on her side to prevent supine hypotension.

24. The young prenatal patient with gestational diabetes mellitus (GDM) says, "I am frightened that I will have to deal with insulin injections for the rest of my life." The nurse's best response would be:

d. "It will most likely resolve 6 weeks or so after the baby is born."

26. The nurse educates prenatal patients about the threat of TORCH infections. Which infections are included in this classification? Select all that apply.

a. Toxoplasmosis

c. Cytomegalovirus

d. Rubella

e. Herpes simplex

27. The nurse emphasizes to a patient with a high-risk pregnancy that the impact of such a pregnancy might result in which problem(s)? Select all that apply.

a. Disruption of family roles

b. Financial pressures

d. Frustration with activity restriction

e. Alteration in child care practices

28. A patient who is 30 weeks pregnant delivers a stillborn child in the emergency department (ED). What should the ED nurse offer the patient? Select all that apply.

a. Privacy

b. An opportunity to hold the infant

c. Materials about support groups

d. A memento (footprint or lock of hair)

e. An opportunity to grieve

29. What would the nurse include in a teaching plan for the pregnant patient who has iron deficiency anemia and has been placed on iron supplement? Select all that apply.

a. Citrus fruits enhance absorption of iron.

d. The iron therapy will continue for about 3 months.

e. Tea should be avoided while taking iron.

30. The nurse takes into consideration that the patient with placenta previa is at risk for postpartum infection for what reason(s)? Select all that apply.

a. Vaginal organisms can invade the placenta.

d. The placenta is an excellent growth medium.